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Biomedical subjects

Karen Francis

Publications and source records attributed to Karen Francis.

At least 19 recordsLinked to original sources
PubMed2006

Adenosine stimulates connexin 43 expression and gap junctional communication in pituitary folliculostellate cells.

Adenosine is known to stimulate interleukin (IL)-6 and vascular endothelial growth factor (VEGF) secretion from pituitary TtT/GF folliculostellate [corrected] (FS) cells indicating that it is an important paracrine regulator of anterior pituitary function. This study demonstrates that rodent anterior pituitary cell lines produce extracellular adenosine that is able to increase intercellular gap junction communication in FS cells. Ecto-5'-nucleotidase (CD73), the enzyme that generates adenosine from AMP, was demonstrated by immunocytochemistry in approximately 20% of anterior pituitary cells, and some of these cells colocalized with prolactin and growth hormone. CD73 mRNA and protein were detected in GH3 and MMQ (somatotroph-lactotroph lineages) and TtT/GF cells, and enzyme activity was demonstrated by the conversion of exogenously added fluorescent ethenoAMP to ethenoadenosine. Adenosine production, as measured by HPLC, was detected in GH3 (1 microM/h) and MMQ (3 microM/h) but not in TtT/GF cells. Adenosine (EC50: 0.5 microM) and NECA (universal adenosine receptor agonist; EC50 0.1 microM) stimulated connexin 43 (Cx43) mRNA and protein expression within 1-2 h in TtT/GF cells. Adenosine and NECA also stimulated gap junctional intercellular communication (as assessed by transmission of Alexa Fluor 488) by 6- to 8-fold in comparison with untreated TtT/GF cells. In cocultures of MMQ and TtT/GF cells, Cx43 expression in TtT/GF cells increased in proportion to the number of MMQ cells plated out. These data suggest that adenosine, formed locally in the anterior pituitary gland can stimulate gap junction communication in FS cells.

5'-Nucleotidase↗
PubMed2006

Mentoring matters: developing rural nurses knowledge and skills.

Mentoring, the alliance of two people with varying degrees of experience in order to create opportunities for support and learning, is being encouraged as a response to current workforce issues in Australian rural nursing. The nursing profession is beginning to recognise the benefits of mentorship in providing psychosocial support and role acquisition skills to novice practitioners. These outcomes are valuable for enhancing the recruitment and retention of staff. The Mentor Development and Support Project of The Association for Australian Rural Nurses (AARN), established in 2003, was a strategy for increasing mentoring in the rural nursing workforce. This project aimed to develop the capacity of rural nurses to mentor effectively, as well as provide support for them for the duration of the mentoring partnership. This article reports on aspects of the AARN project. It includes a discussion of the need for planned mentor development opportunities and provides the rationale for the curriculum content of project workshops. It also includes evaluated outcomes for participants in the project.

Australia↗
PubMed2006

Adopting a constructivist approach to grounded theory: implications for research design.

Grounded theory is a popular research methodology that is evolving to account for a range of ontological and epistemological underpinnings. Constructivist grounded theory has its foundations in relativism and an appreciation of the multiple truths and realities of subjectivism. Undertaking a constructivist enquiry requires the adoption of a position of mutuality between researcher and participant in the research process, which necessitates a rethinking of the grounded theorist's traditional role of objective observer. Key issues for constructivist grounded theorists to consider in designing their research studies are discussed in relation to developing a partnership with participants that enables a mutual construction of meaning during interviews and a meaningful reconstruction of their stories into a grounded theory model.

Abstracting and Indexing↗
PubMed2006

Baccalaureate nursing studies: voyaging towards discovery.

Postregistration nursing courses are designed to enable registered nurses to convert their existing certificate or diploma qualifications to degree level. This paper presents the findings of a preliminary exploratory, descriptive investigation into the experience of nurses undertaking postregistration degree studies in Malaysian Borneo. The unique nature of this environment presents challenges for these students and these are examined using the metaphor of a ship's voyage. These experiences are explored within themes of setting sail, finding one's sea legs, all in the same boat and discovering the treasure. The findings indicate that, for most of the participants, completion of a baccalaureate postregistration course was a long-held goal. A number of challenges were faced during the course, including managing time, the stress of conflicting priorities and the adjustment to tertiary studies. Support from fellow students, faculty and family was crucial to successfully completing this course. Personal and professional changes were reported by all participants. These include an increased level of confidence and assertiveness, the development of critical thinking ability, and enhanced communication skills. Ultimately, participants reported a renewed attitude towards themselves and their profession.

Borneo↗
PubMed2006

The study of nursing documentation complexities.

This study aimed to explore complexities in nursing documentation and related factors. Nursing documentation has been one of the most important functions of nurses since the time of Florence Nightingale because it serves multiple and diverse purposes. Current health-care systems require that documentation ensures continuity of care, furnishes legal evidence of the process of care and supports evaluation of quality of patient care. However, nursing documentation has not served such objectives because of its complexities. This study explores nursing documentation complexities and related factors through both qualitative and quantitative methodologies. The study used multiple methods of inquiry: in-depth interviewing; participant observation; nominal group processing; focus group meetings; time and motion study of nursing activities; and auditing of completeness of nursing documentation. Complexities in nursing documentation include three aspects: disruption, incompleteness and inappropriate charting. Related factors that influenced documentation comprised: limited nurses' competence, motivation and confidence; ineffective nursing procedures; and inadequate nursing audit, supervision and staff development. These findings suggest that complexities in nursing documentation require extensive resolution and implicitly dictate strategies for nurse managers and nurses to take part in solving these complicated obstacles.

Documentation↗
PubMed2006

The development of nurse practitioners via flexible learning: toward an innovative Masters degree curriculum in Thailand.

The changing health system in Thailand has provided Thai people with more equitable opportunities in accessing health care services. As a result of medical practitioner shortages and a strong desire for nurses to expand their scope of practice, the Thailand Nursing and Midwifery Council (TNC) plans to increase the number of nurse practitioners at master degree level to staff primary care units (PCUs) and Health Centres around the country. Nursing master degree curricula in Thailand are currently offered using the traditional on-campus face-to-face mode of delivery and have low numbers of student enrolments. Furthermore, research indicates that many graduate nurses in Thailand are seeking entry to master degree curricula, but accessibility, convenience and availability of curricula locally are limiting enrolments. Nursing education globally is a dynamic and iterative process. Educational curricula are based on the principles of adult learning, continuing professional education and life-long learning, which advocate flexible and learner-oriented education. Flexible learning, which has the ability to closely match the professional and academic needs of the learner, has the potential to lead nursing education toward meeting the TNC policy and health system reform in Thailand. It is essential that nursing education in Thailand be revolutionised, embracing flexible delivery modes by traditional higher education providers. This paper presents a new model of health care service delivery and the mechanism used to integrate the principles of flexible learning into a new master degree curriculum for nurse practitioners (NPs) in Thailand.

Curriculum↗
PubMed2006

The experience of whanau caring for members disabled from the effects of a cerebro-vascular accident.

The study sought to understand the experience of Māori in accepting responsibility for the care of a whanau member following a cerebro-vascular accident (CVA). The importance and role of whanau, kaumatua and kuia to Māori as a distinctive ethnic entity is well known and acknowledged in coming to an understanding of Māori society. Whanau has a very large part to play in the care of the family member disabled by CVA. There is extensive literature that deals with these issues, yet there is little that deals with disability issues and in particular those issues that arise following CVA. A qualitative study was conducted examining the experience of Whanau caring for members disabled from the effects of CVA. Individual and focus group interviews were undertaken with Māori patients and their caregivers to explore this phenomenon. Data were analysed using a thematic analysis approach and highlighted three time stages of concern, namely (1) the onset of the event, (2) hospitalisation, and (3) discharge care.

Caregivers↗
PubMed2005

Human osteoblast precursors produce extracellular adenosine, which modulates their secretion of IL-6 and osteoprotegerin.

UNLABELLED: We showed that human osteoprogenitor cells produced adenosine and expressed ecto-5'-nucleotidase and all four adenosine receptor subtypes. Adenosine stimulated IL-6 but inhibited osteoprotegerin secretion, suggesting that adenosine is a newly described regulator of progenitor cell function. INTRODUCTION: Maintaining skeletal homeostasis relies on there being a balance between bone formation and resorption; an imbalance between these processes can lead to diseases such as osteoporosis and rheumatoid arthritis. Recent reports showed that locally produced ATP, acting through P2 receptors, has pronounced effects on bone formation. However, ATP can be enzymatically cleaved to adenosine that has little or no activity at P2 receptors but mediates its action through the P1 family of receptors. We studied whether adenosine may also have an important role in controlling bone cell differentiation and function. MATERIALS AND METHODS: Extracellular adenosine levels were analyzed by high-performance liquid chromatography in HCC1 and bone marrow stromal (BMS) cells. Ecto-5'-nucleotidase (CD73) expression and activity was determined by RT-PCR, immunocytochemistry, and the cleavage of etheno-AMP to ethenoadenosine. Adenosine receptor expression and activity were determined by RT-PCR and cAMP measurements. The effects of adenosine receptor agonists on IL-6, osteoprotegerin (OPG), and RANKL expression were determined by ELISA and QRT-PCR. RESULTS: HCC1 and BMS cells produce adenosine and express CD73 and all four adenosine receptor subtypes. The A2b receptor was shown to be functionally dominant in HCC1 cells, as determined by cAMP production and in its stimulation of IL-6 secretion. Adenosine receptor agonism also inhibited OPG secretion and OPG but not RANKL mRNA expression. CONCLUSIONS: Our findings show that HCC1 and primary BMS cells produce adenosine, express CD73 and all four adenosine receptor subtypes. In HCC1 cells, adenosine has a potent stimulatory action on IL-6 secretion but an inhibitory action on OPG expression. These data show for the first time that adenosine may be an important regulator of progenitor cell differentiation and hence an important local contributor to the regulation of bone formation and resorption.

5'-Nucleotidase↗
PubMed2005

The influence of HIV/AIDS on the practice of primary care nurses in Jordan: rhetoric and reality.

The role of nurses in raising community awareness about HIV/AIDS is well-reported. However, little is known about the practice of Jordanian nurses and the role they play in the prevention and control of HIV/AIDS. This interpretive ethnographic study sought to illuminate the role of primary care nurses and examine the influence of HIV/AIDS on their practice. The study was undertaken in Jordan in three rural and three urban primary health-care centres. Data collection included participant observation, key informant interviews and document analysis. These data informed the development of descriptive ethnographic accounts that allowed for the subsequent identification of common and divergent themes reflective of factors recognized as influencing the practice of the nurse participants. The findings indicate that the rhetoric offered by all levels of administration and endorsed in policy is not reflective of the reality of practice. Poor resources and educational preparation, a limited nursing skill mix and access to professional development, lack of nursing leadership and role models, cultural beliefs and geographic isolation are factors that reduced the capacity of the primary care nurses to raise awareness and, therefore, influence the prevention and control of HIV/AIDS.

Attitude of Health Personnel↗
PubMed2004

What are the information needs of Chinese breast cancer patients receiving chemotherapy?

Cancer patients demand information, not only to assist them to understand the disease and its treatment, but also to allow them to interpret the aversive events and action taken, so that the threat inherent from the diagnosis becomes lessened. With the goal of studying the information needs of women with breast cancer who were receiving chemotherapy, 51 patients were invited to complete a self-administered questionnaire at the beginning and again at half way through their chemotherapy treatment. The results showed that for these patients the cancer and its spread, the side effects of chemotherapy and the management of the side effects were the priority information needs in the early stages and following chemotherapy. Among 52 questions, only six items were revealed to have significant difference when compared with the Time 1 and Time 2 measures. The results reflect that over time information needs for this group of patients was relatively stable. Marital status and subscale of disease was found significant difference at the first and second time points. The findings indicate that there is a need for the provision of a family-centered education program that addresses patient's information needs, cultural sensitivity, the use of building up and ongoing.

Adult↗
PubMed2004

Research an exciting journey and a career statement: a means to an end, putting rurality on the nursing research agenda.

Two issues were of importance to nurses in rural areas considering postgraduate studies. The first was the need for part-time study and what this entails. The second was a request that there be no research component within the postgraduate courses they identified. It is this second issue that I wish to address. I was a nonbeliever in the merit of research studies being integrated into nursing specialist programs. Following a long career in rural clinical nursing and management I have come full circle and now acknowledge the need to understand the role to base practice evidence that is generated through empirical research.

Education, Nursing, Graduate↗
PubMed2003

Complement C3a receptors in the pituitary gland: a novel pathway by which an innate immune molecule releases hormones involved in the control of inflammation.

Two-way communication exists between the endocrine and immune systems using molecules such as hormones and cytokines. Here we describe a new pathway by which C3a, a complement-derived cytokine, stimulates anterior pituitary hormone release and activates the hypothalamic-pituitary-adrenal axis, a reflex central to the stress response and to the control of inflammation. We show that C3a receptors are expressed in pituitary hormone secreting and non-hormone secreting (folliculostellate) cells and that both C3a and C3adesArg (a non-inflammatory metabolite) stimulate pituitary cell cultures to release prolactin, growth hormone, and adrenocorticotropin. Serum levels of these hormones, together with adrenal corticosterone, increase dose dependently with recombinant C3a and C3adesArg administration in vivo. Pertussis toxin blocks the response to C3a but not C3adesArg, which indicates the presence of two receptors, only one of which is coupled to Galphai-proteins. We propose that the complement innate immune molecules (cytokines) modulate tissue-specific and systemic inflammatory responses through communication with the endocrine pituitary gland.

Animals↗